The Ecosystem of Primary Care

[摘要] This is certainly what I see when I pictureprimary care as a system of diverse butinteracting general practices, all connectedthrough common goals. But this is anecosystem in danger, whose foundationshave been battered by underfunding,a recruitment and retention crisis, and apandemic that has changed the nature ofaccess and how we work with our patients.In the depleted landscape of primarycare, what needs cultivating and whatshould be left alone? How do ecosystemsfind their shape and natural form? In hisbook Feral, George Monbiot argues thatnature responds when we stop trying tocontrol it and proposes steps we can take to rewild ecosystems, an analogy IonaHeath discussed here in the BJGP in aprevious editorial about rewilding generalpractice.2,3 In health care, what fences canwe tear down? What can we cull back, andwhat should we introduce back into theecosystem of primary care.

[学科分类] 卫生学